As an alternative to traditional surgical techniques or methodologies, percutaneous surgery has been found to significantly reduce morbidity and post-operative recovery time. A fundamental problem in clinical delivery of percutaneous therapy and needle biopsy is precise placement of the percutaneous needle in inhomogenous soft tissue. The accuracy of delivery is dependent upon both accurate targeting and on the precise driving of the needle on the target. In conventional systems and methods, the targeting accuracy exceeds and often greatly exceeds the driving accuracy that can be achieved. Furthermore, a wide spectrum of treatment methods require that the percutaneous needle be held firmly in the target location for a considerable period of time while the patient is in repiratory, cardiac and muscular motion.
This need for accurate delivery initially required that the surgeon performing the procedure have an extensive amount of experience and skill, however, there were shortcomings with such procedures. For example, then existing radiological image guidance techniques could not provide effective three-dimensional information to the surgeon regarding needle insertion. Consequently a number of robotic systems were proposed to assist in placement of the needle. Such robotic system solutions are found in “Intraoperative Imaging Guidance for Keyhole Surgery Methodology and Calibration,” Potamianos, P. Davies, B. L. and Hubbard, R. D., Proceedings for the First International Symposium on Medical Robotics and Computer Assisted Surgery, Pittsburgh, Pa., pp. 98-104 (1994); “Intraoperative Imaging Guidance for Keyhole Surgery Methodology and Calibration”, Potamianos, P. Davies, B. L. and Hubbard, R. D., Proceedings for the First International Symposium on Medical Robotics and Computer Assisted Surgery, Baltimore Md., pp. 156-164 (1995); “An Automated System for Precise Pecutaneous Access of the Renal Collection System”, Bzostek, A., Schreiner, S., Barnes, A. C., Cadeddu, J. A., Roberts, W. Anderson, J. H., Taylor, R. H. and Kavoussii, L. R. submitted for review to the Proceedings of the First Joint Conference of CVRMed and MRCAS, Grenoble France (1997) and PCT Publication No. WO 989/3688, published Aug. 27, 1998. A number of other robotics systems and methods for use in connection with surgical procedures, including sub-systems, methods and/or device related thereto, are found in U.S. Pat. Nos. 5,086,401; 5,299,288; 5,408,409; 5,279,309; 5,695,500; 5,630,431; 5,445,166; 5,402,801; 5,950,629; 5,976,156; 5,417,210; 5,572,999; 5,749,362; and 5,397,323.
Conventional needle drivers for percutaneous therapies typically utilize a friction transmission to achieve motion along the translational axis or idealized travel path, translational motion, to guide a needle into a soft tissue target. The translational axis is the axis along which the percutaneous needle generally travels to the soft tissue target. Such conventional friction transmission needle drivers, however, have a few shortcomings.
A frictional transmission has limited accurate encoding to track the translational position of the needle. For example, needle slippage results in loss of encoding, which in turn results in loss of accurate positioning of the needle in the translation axis. Needle slippage occurs when the force experienced by the needle is greater than the product of the preload contact force and the dynamic coefficient of friction. Needle deviation from the planned target also can occur because of needle deflection, organ deformation and respiratory, cardiac or muscular motion. Needle deflection can result from high needle insertion forces, the forces necessary for penetration into the tissue target, which is greatest at the initial point of entry. Needle deflection is a particular concern due to tissue inhomogeneities which in effect creates more of entry points for the needle as it traverses within the body.
It thus would be desirable to provide an improved new device, apparatus, system and related methods so a needle or other penetrating member can be accurately driven into an identified target in a soft tissue target and also retain encoding. It would be particularly desirable to provide such a device, apparatus, system and method that reduces or minimizes insertion forces in comparison to prior art devices and methods while the needle is being translated. It also would be desirable to provide such a device, apparatus, system and method that would lead to more accurate final positioning of the needle as compared to prior art devices. Further, it would be desirable to provide a device, apparatus, system and method providing more accurate encoding and tracking of translational needle position as compared to prior art device and methods. Such devices, apparatuses, systems preferably would be simple in construction and less costly than prior art devices and such methods would not significantly increase the complexity of surgical techniques to utilize the device, apparatus or system.